Healthcare Provider Details

I. General information

NPI: 1518907831
Provider Name (Legal Business Name): UNIVERSITY RADIATION ONCOLOGISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 09/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 EAST CIRCLE OF HOPE STE. 1570
SALT LAKE CITY UT
84112-5550
US

IV. Provider business mailing address

PO BOX 413031
SALT LAKE CITY UT
84141-3031
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-8793
  • Fax:
Mailing address:
  • Phone: 801-236-7747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DENNIS C SHRIEVE
Title or Position: DEPARTMENT CHAIR
Credential: MD
Phone: 801-581-8793